The ups and downs of yo-yo dieting can cause both physical and psychological stress
“Too much vigor in the beginning of an undertaking often intercepts and prevents the steadiness and perseverance always necessary in the conduct of a complicated scheme.”
– Samuel Johnson
Up and down, down and up. Susie was a yo-yo dieter, and had been for 25 years.
“I don’t understand it! I am so passionate about being healthy! I lose weight for a while. People say I look great. It’s all new and exciting. But after a few months I start going up again, and sometimes I’m even heavier than I was when I started the damn diet!”
In a few short sentences Susie had described her problem perfectly. And I knew I could help her.
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“I even had difficulty getting passport control to believe it was really me in a recent passport pic! I’ve put on that much weight!”
Up and down all the time. People lose weight initially, then end up eating more than they had before they even started dieting, and either return to their pre-diet weight – or more! It’s a common pattern.
But there may be major consequences to yo-yo dieting.
The heart of the matter
One study, worryingly entitled ‘Yo-Yo dieting dangerous even if you’re not overweight’, investigated the weight and dietary history of 158,000 postmenopausal women. The research found that those who reported large and frequent weight fluctuation due to yo-yo dieting (starting off at a “normal weight”) were 3.5 times more likely to die of sudden heart attack than women of more stable weight.[1]
The researchers also found that women whose weight was within the normal healthy range who started yo-yo dieting increased their risk of dying of a heart attack by 66%.
Yet there was no correlation between the risk of dying of a heart attack and weight gain in itself, nor weight loss. Herein lies the key.
It’s the oscillation of weight that seems to do the damage.
Another study written up in the International Journal of Exercise Science showed that yo-yo dieting increases bodily inflammation,[2] which has been linked to all kinds of diseases, from cancer to diabetes and allergies to Alzheimer’s.
Susie’s weight had fluctuated massively over the past quarter-century. Was it a coincidence she’d suffered from a whole host of health issues, including mood swings?
I suggested that some things in life, like a sea crossing, a plane flight or interior decoration, were best served by steadiness and balance. I wanted to see the pattern. Why had Susie gone up and down so much? And more importantly, how could we stabilize her at a healthy, sustainable weight?
Here are a few ideas if you are faced with constantly shape-shifting clients.
Tip one: It’s not all about the passion
Right off the bat Susie had said, “I don’t understand it! I am so passionate about being healthy!”
It struck me as strange, but also very telling.
‘Passion’ has become a buzzword. In order to demonstrate you are a committed person, you write in CVs, state publically on ‘reality’ TV, and proclaim proudly in presentations that “I’m really passionate about [fill in the blank].” And that’s fine – but not if it’s all you’ve got.
You can be passionate about brain surgery, but if the drill sends shivers down your spine, you won’t get far. And you can be as passionate as you like about winning, but if you don’t take time to build your skills you’ll still end up losing. And, to use a bit of a more dramatic example, the world would have been far better off without the vitriolic passion of the Nazi Youth League.
Like any form of fuel, passion is great in short bursts but not so much for long-term sustainability. To overemphasize ‘passion’ can be a mistake, because some people end up believing it’s all they need and feel disappointed when they don’t get sustainable results.
I suggested to Susie that the brightest flame may not burn the longest. She had never really thought about this. “Reaching and maintaining a good weight needs to be just a thing you do”, I suggested.
Do you have to be passionate about cleaning your teeth? Washing your clothes? Saying please and thank you? If we could only do these things while we were excited about them, we wouldn’t do them for long.
Ascertain how your client feels each time they adopt a new diet. If they are full of passion that actually might sound warning bells.
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I had Susie envisage, while in a deeply relaxed state, doing things to maintain a balanced weight without having to think about it too much – for weeks, then months, then years… “because it’s just what you do.”
Related to the passion trap is panacea thinking.
Tip two: The answer to everything
“I’ve tried them all. Vegan diets, the Atkins diet, three-day fasts, the Mediterranean diet, the Zone diet…” Susie described how she always felt each new diet was going to be “the one”, how she would get excited and love the newness of it. “It’s like… this diet will fix everything in my life!” she told me. “That’s how it always feels.”
Addiction to novelty, like passion, isn’t sustainable. As soon as the diet gets old, it gets unappealing. So it was for Susie: “Once the excitement of its newness wears off, I revert back to my old eating habits.”
No diet is a panacea. The body is complex and also adjusts. I suggested to Susie we all need excitement and novelty but changing our eating pattern isn’t necessarily the best way to meet that need.
Susie told me she wanted to try new activities and meet new people. We explored this and together devised steps to help Susie start to do just that. Susie needed to keep her need for excitement and novelty away from her eating.
“Eating can just be eating, can’t it!” she said. “Yes!” I said, victoriously.
But then Susie said something else.
“Mind you, I do like the compliments when I slim down again. The trouble is, after a time people get used to me being slimmer again and stop talking about it. And that’s often a trigger for me to think, “Oh well, I might as well eat what I like again, you know, cakes, bread, sweets…”
This took us down another line of focus.
“Who exactly is this for?” I asked her.
Tip three: Reward needs to be intrinsic
I talked to Susie about research that showed how, for children, too much praise for an activity they had been enjoying for its own sake (such as drawing) can make them lose interest in it.[3]
Their focus changes from intrinsic satisfaction – the love of doing it for its own sake – to extrinsic reward – “This is only worth doing if I’m praised for it!”
“It’s too fragile,” I suggested, “if we just wait for others to praise us. Yes, praise is great, but people are so used to you going up and down in weight anyway. If you depend on praise to maintain your motivation, then you are handing over the reigns of power to other people. This is your life, Susie!”
Susie was now pensive. “Yes, I’m doing this for me aren’t I!”
“Yes, you are. Do you stop cleaning your teeth when people stop praising you for doing it?” I asked from far-out left field.
She laughed. “No! Nobody praises me for cleaning my teeth!”
“Exactly!” I said. “But you still do it.”
I then asked her to tell me about what she called her “relapses”, her crashes out of healthy eating patterns.
Susie said something I’d heard many times, and I’m sure you have too.
Tip four: Avoid the rubber-band effect
“It’s like the pressure builds. I’ve been good for so long, and then wham! The diet is no longer new and exciting. People have stopped noticing. I’ve had a bad day in the office. And I think, to hell with it! Why deny myself? I’m going to have a treat! And hey presto, I’m right back where I started, or worse, fatter than when I started!”
Pressure builds. But why? Why does there have to be pressure? This is what I call the ‘rubber-band effect‘. We exert effort by pulling in the opposite direction of whatever it is we don’t want to do. We desperately determine we are not going to text our ex, or drink wine, or eat cake. We forbid ourselves. We deny ourselves. When we do that, focus builds, and so can desire.
I suggested Susie could become less of an “extremist”, less all-or-nothing. That she could start to sustain her healthy weight, to eat “properly” 85% of the time. She could give herself a few pounds’ leeway and need not be too tight in her insistence on sticking to a specified weight. I also said something else:
“Susie, if you climbed 100 steps but then paused, maybe got distracted, maybe got a bit tired and stumbled, perhaps stepped back down a step or two… would that mean you hadn’t climbed the other 98? Would you have to go all the way to the bottom again?”
She laughed. “I see what you mean!” Months later she told me that still stuck in her mind. Analogies often do.
“And what’s this treat business?” I asked her.
Tip five: Reframe ‘a treat’
Susie had spoken about having “treats”.
The idea of sugar-laden quick energy, empty calories, inflammation-inducing mock foods as ‘treats’ is often conditioned into us as young children. “If you’re good you can have some insulin-stimulating, teeth-rotting, subcutaneous-fat-storing goodies!” said no parent ever.
During hypnosis I talked about not denying her bones, her heart and her general health the ‘treat’ of being healthy and staying in the world for as long as they were supposed to.
I suggested her heart could speak to her about what it wants, and so too could every cell of her body. That she could work with her body and enjoy that for its own sake, without ever having to get excited about or complimented for filling herself with top-quality fuel.
Susie emailed me a few months later saying her weight had stabilized at a healthy level.
After 25 years, she finally felt different and natural.
Helping a client change their perspective for the better can allow them to break away from unhelpful habits. And you can perfect your reframing skills with our Conversational Reframing course. Click here to be notified when the reframing course is open for booking.
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About Mark Tyrrell
Psychology is my passion. I've been a psychotherapist trainer since 1998, specializing in brief, solution focused approaches. I now teach practitioners all over the world via our online courses.
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Notes:
(1) http://newsroom.heart.org/news/Xyo-yo-dieting-dangerous-even-if-youre-not-overweight
